Homestead_LashbrookCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R6 14M)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions_
I (We) LA-� I "�Y !�
l ((We /)yccupied as our principal place of residence the
LP'I (VJe) owned ❑ Are buying under contract
N L k_! � \ certify
described real property for which a Homestead
FORM YEAR 8D-1
lit.
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
NTRACTRE_CORDEDa�c�"^
If buying on contract. Fee Simple owner's name
Recorders office where contract is recorded Record number Page
��„', �. �" 3` �, '���:;��'�;)��`7�,„"'{"•',$� °' �"`PROP.ERTY�OWNEDBY:CIAIMANT I'N OTHER' COUNTIES; kr�'., �;.' �,a��i€�'�`?".��_�I?,�"�;Y'1)r; M1�t+�{�p
County Township
PROPERTY. DESCRIP, TIDN�.. F `x`Y�,�-o- =�'�';"�r���'�'Za,. "'
County
Toxnship
Address (number and sheet city, state, ZlP code)
o•� iiw.. i� • S.� X z Irk IF
Taxing "ct (' own, township)
ParS�l number
(J
L s dption
�/
/
Is the props in on:
Raal property ❑ Mobile Homo (I.C. 6-1.1 -7)
if any portion of the residential structure or the land not exceeding one (1 j acre that i mediatety wrnounds that swcwre is used b Droduco income, describe the use and portion
of the property ut l'¢ed to produce income.
Ll-
��„', �. �" 3` �, '���:;��'�;)��`7�,„"'{"•',$� °' �"`PROP.ERTY�OWNEDBY:CIAIMANT I'N OTHER' COUNTIES; kr�'., �;.' �,a��i€�'�`?".��_�I?,�"�;Y'1)r; M1�t+�{�p
County Township
County Township
I hereby certify the above statements are We, correct and complete.
Si re of claimant
Address (number and sheet city, state, ZlP code)
o•� iiw.. i� • S.� X z Irk IF
i°� -
ASSESSORR USE -ONLY
f ?ASK F4S: x
" -ter
TAX
ALl1E
"SSESSEDVALUE
AT.t100Ya'OFTTV3
<rr5-VALUE @ _
IdESTEAD
�
v.o . -& Y i
NON= REStDENT1AL,f^Y
' yVALUEE!
Land not exceeding 1 (one) acre immediately
surrounding residential Improvements.
=- 'j"'S' -��; u?_
Other land
(2)
IS
.e:. - -.. �a
e e-...xak'
Total land (line 1 plus line 2)
(3)
Residential Improvements or Annually"`
Assessed Mobile / Manufactured Home
Dwelling
Garage
(4)
(5)
a.. f _ 4 MW
Other improvements
(6)"
"
Trial improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(6)
1 hereby certify the above Is true, correct, and
complete.
Signature of AS ssor
Date signed
Verifying action - Signature of Auditor
Date signed
DARD '.DEDUCTIONALLOWANCEI"'s-''
20_Pay 20_
Lesser of 1Yt Homestead
vser of 1 or Homestead
$
Signature of Auditor Date signed
STV E FORM 53NtR2rat TP.E<SDREJ FORM TS-IA
.or mutt n BY<ISTE frhARDNI Mrrti<R<,wv PREYRthFD BY THE DEPARTMENT OF LOCAL GOVEEINIENT FEASCE W Vr.I-t'-F.t
Gibson
11N Main County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
PRINCETON IN 47670 IndividuaLs and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than eta for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 13-14-3009 requires taxpayers who receive the homestead standard deduction to verity hat they are elicibie to receive the
® benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing.This information will be Lepi confdemial and can only he accessed by authorized county officials.The Department of
Local Government Finance will we this information to create tools that will help county officials eliminate homestead Gaud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Lashbrook, Daniel
942 S Cr 700 E
Winslow IN 47598
4563
Daniel Lashbrook
309E Wood St State Parcel Number Legal Description
FRANCISCO IN 47649-9085
�t�n��ut�t��nt�n��t�n�t�n��u r�n�n�t lt'IFUIFIu'Flttl 26-13-20-101-000-060-005 012-00060-00 PARKVIEW 4PT/5
PART 2:TAXPAYER INFORMATIONN
Owner I //�/ First Middle // Last
_ .�� a( /dS7A-o 4, C Lynn Zari .1 ord
•tn Address(number and stmt.city,state,and ZIP code) ---" --- Same is propcny udaless —- — ' --
34'0 2-clAyr / u�
Spouse First Middle,,,_�� Last
Mailing Address(Number and street,city,slate,and ZIP code) Same as properly address
Social Security Number(Iasi 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sox
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner 1 Signature Date
PART 4:ADDITIONAL INFORMATION
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